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A28    SCIENCE
                 Friday 14 September 2018
            Calling teen vaping 'epidemic,' officials weigh flavor ban




            By MATTHEW PERRONE                                                                                                  quirement has allowed the
            WASHINGTON  (AP)  —  U.S.                                                                                           industry to flourish with little
            health  officials  are  sound-                                                                                      oversight.  But  it's  not  clear
            ing  the  alarm  about  teen-                                                                                       how  quickly  the  decision
            age  use  of  e-cigarettes,                                                                                         could be reversed.
            calling  the  problem  an                                                                                           Wells  Fargo  analyst  Bon-
            "epidemic"  and  ordering                                                                                           nie  Herzog  said  Juul  is  the
            manufacturers  to  reverse                                                                                          brand  "most  at  risk"  from
            the trend or risk having their                                                                                      an  FDA  crackdown  and
            flavored  vaping  products                                                                                          that a potential ban on the
            pulled from the market.                                                                                             company's products would
            The warning from the Food                                                                                           boost Altria and other ciga-
            and Drug Administration on                                                                                          rette  makers  that  also  sell
            Wednesday  cited  recent                                                                                            e-cigarettes.
            data  pointing  to  a  sharp                                                                                        Shares of Big Tobacco com-
            rise in underage use of the                                                                                         panies  surged  in  trading
            devices,  including  Juul,                                                                                          Wednesday.  Altria  Group
            Vuse and others.                                                                                                    Inc.  and  British  American
            It marks a shift in the agen-                                                                                       Tobacco  Plc  had  the  big-
            cy's  tone  on  e-cigarettes.                                                                                       gest  one-day  percentage
            Since  2017,  FDA  commis-                                                                                          gain in about a decade.
            sioner  Scott  Gottlieb  has                                                                                        San  Francisco-based  Juul
            discussed  e-cigarettes  as                                                                                         said it is working to prevent
            a  potential  tool  to  ween                                                                                        underage  use  of  its  prod-
            adult  smokers  off  ciga-                                                                                          ucts but added that flavors
            rettes,  although  that  ben-                                                                                       can  help  adult  smokers
            efit hasn't been proven.                                                                                            quit.
            But Gottlieb said in an ad-                                                                                         "By  working  together,  we
            dress at FDA headquarters                                                                                           believe we can help adult
            that  he  failed  to  predict                                                                                       smokers  while  preventing
            the  current  "epidemic  of                                                                                         access to minors," the com-
            addiction"  among  youth,    This Dec. 4, 2013 file photo shows vials of flavored liquid at a store selling electronic cigarettes and   pany said in a statement.
            mainly  driven  by  flavored   related items in Los Angeles.                                                        The  FDA  also  announced
            products.                                                                                          Associated Press   1,300  warning  letters  and
            "The  disturbing  and  accel-                                                                                       fines  to  online  and  tradi-
            erating  trajectory  of  use  have warned nicotine in e-  come  one  of  our  biggest  most  products  for  review  tional  stores  that  have  ille-
            we're  seeing  in  youth  and  cigarettes is harmful to de-  challenges," he said, in pre-  by  August  2018.  But  last  gally sold Juul and other e-
            the  resulting  path  to  ad-  veloping brains.           pared  remarks.  "Hindsight,  year  Gottlieb  delayed  the  cigarettes to minors. Regu-
            diction must end," Gottlieb  They typically contain nico-  and  the  data  that's  now  deadline  until  2022,  saying  lators said it was the largest
            told  agency  staffers  and  tine, and sometimes flavor-  available to us, fully reveal  both  the  agency  and  in-  coordinated crackdown in
            reporters.                   ings like fruit, mint or choco-  these trends."           dustry  needed  more  time  the agency's history.
            The  FDA  said  it  remains  late.                        In  June,  a  government  to prepare.                     The  FDA  is  in  the  process
            committed  to  exploring  e-  Health  advocates  have  survey  found  teen  vap-       The  decision  was  criticized  of  rolling  out  a  sweeping
            cigarettes as a less-harmful  worried  about  the  popu-  ing  seemed  to  be  holding  by anti-smoking advocates  anti-smoking  initiative  de-
            alternative  for  adult  smok-  larity  of  vaping  products  steady last year. Some ex-  who  say  e-cigarette  mak-  signed  to  make  it  easier
            ers,  but  Gottlieb  added  among  kids  and  the  po-    perts  were  cautious  about  ers  are  targeting  kids  with  for  smokers  to  quit  by  cut-
            "that  work  can't  come  at  tential  impact  on  smoking  the  results,  however.  They  candy flavors and market-  ting  the  nicotine  levels  in
            the expense of kids."        rates  in  the  future.  A  gov-  noted  the  survey  did  not  ing that portrays their prod-  regular  cigarettes.  As  part
            E-cigarettes   are   vapor-  ernment-commissioned  ask specifically about Juul,  ucts  as  flashy,  hand-held  of  that  plan,  Gottlieb  has
            emitting devices that have  report  in  January  found  a  sleek,  heavily-marketed  gadgets.                       suggested  some  smokers
            grown  into  a  multi-billion  "substantial evidence" that  e-cigarette  brand  that  ex-  Under  Wednesday's  an-  could  be  directed  toward
            dollar  industry  in  the  U.S.  young  people  who  use  e-  ploded  onto  the  market  nouncement, the five larg-  alternative  products  that
            despite  little  research  on  cigarettes  are  more  likely  and  accounts  for  70  per-  est  e-cigarette  manufac-  deliver nicotine without the
            their  long-term  effects,  in-  to try cigarettes.       cent  of  U.S.  sales,  accord-  turers  will  have  60  days  to  carcinogens  of  cigarettes.
            cluding  whether  they  are  Gottlieb  cited  unreleased  ing to analyst estimates.    produce  plans  to  stop  un-  Those  products  could  in-
            helpful  in  helping  smokers  federal figures that he says  "I  think  it  became  clear  to  derage  use  of  their  prod-  clude e-cigarettes, though
            quit. They're generally con-  will be made public in com-  FDA  that  if  they  didn't  get  ucts.  The  companies  sell  the FDA has not given any
            sidered  a  less  dangerous  ing months.                  their arms around this issue  Vuse,  Blu,  Juul,  MarkTen  company permission to ad-
            alternative to regular ciga-  "We  didn't  foresee  the  the  use  of  these  products  XL,  and  Logic  e-cigarette  vertise its device as a quit-
            rettes.  But  health  officials  extent  of  what's  now  be-  by  kids  across  the  nation  brands, which account for  smoking aid.
                                                                      would  undo  decades  of  97  percent  of  U.S.  e-ciga-  On  Wednesday,  Gottlieb
                                                                      progress,"  said  Matthew  rette  sales,  according  to  criticized  e-cigarette  com-
                                                                      Myers  of  the  Campaign  FDA.                            panies'  handling  of  the
                                                                      for  Tobacco-Free  Kids.  His  If  the  plans  fall  short,  the  underage  use  problem,
                                                                      group  and  several  others  FDA  could  block  sales  of  saying they approached it
                                                                      are  suing  the  FDA  over  a  the  products  by  enforcing  as "a public relations chal-
                                                                      decision  to  delay  federal  a  requirement  that  com-  lenge  rather  than  seriously
                                                                      review of most e-cigarettes.  panies  provide  detailed  considering  their  legal  ob-
                                                                      Under  regulations  devel-   design  and  health  data  ligations."
                                                                      oped  by  the  Obama  ad-    about  their  products  be-  "I'm here to tell them today
                                                                      ministration, manufacturers  fore  marketing  them.  The  that  this  prior  approach  is
                                                                      were  supposed  to  submit  FDA's  delay  on  that  re-   over," he said.q
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